Alberta Health Services is calling for redevelopment plans at the Misericordia Community Hospital to be put on hold for another 20 to 30 years, in part to steer funding to several other massive health projects in Edmonton.

Among the more than $4 billion of pressing needs in the city is a colossal overhaul of the Royal Alexandra Hospital, the construction of a new suburban hospital and the creation of a dozen or so community health centres, AHS says in a new report submitted to the province.

The report, obtained by Postmedia through an access to information request, sheds light on the volume of work needed to address the capital’s badly neglected health infrastructure, while also revealing a significant shift in thinking toward the Misericordia.

The health authority is now recommending a smaller-scale “modernization,” which would see the current structure sufficiently refurbished to keep it viable for at least two more decades.

“It’s a bit of a reality check for us, that we have so many competing priorities in the Edmonton zone,” said Dr. David Mador, AHS vice-president and medical director for northern Alberta.

“Being pragmatic about our current fiscal environment in Alberta, and how long it takes us to proceed with these big projects, there is a realization we can’t afford to be thinking about the Mis in terms of five to 10 years. It has to be much longer than that.”

Asked why the health authority is now recommending the Misericordia be scaled back, Mador said the size of the problems at the Royal Alex makes it a bigger priority.

Although both hospitals have numerous deficiencies, the main treatment areas at the Royal Alex (1962) are older than the Misericordia (1969). As well, the inner-city hospital is arguably more vital, as it contains considerably more beds and serves as one of the main surgery hubs in the province.

Mador also noted that some sections of the Misericordia were recently upgraded, potentially making it easier to modernize the rest of the hospital, including the emergency department and other patient areas.

Should the full redevelopment of the Royal Alex proceed, it would likely become the lengthiest and costliest health project in Alberta history.

AHS is recommending approval of at least the initial phases of the proposal, which together carry a price tag of around $2 billion. These phases include a new child mental health building and clinical services centre, followed by construction of a new inpatient tower with 800 beds.

Besides the Royal Alex, AHS’s priority list also advocates construction of an entirely new hospital called the “Edmonton health campus.”

Mador said the name reflects that the hospital would offer not just critical care, but a comprehensive suite of additional services.

The project is likely destined for a suburban area either in the southwest or northeast, and could potentially become the new home of mental health services now being offered at Alberta Hospital Edmonton.

Also on the priority list for the first time is a proposal to establish a dozen or so community health centres, which would each serve loosely affiliated communities of 100,000 to 125,000 people.

Health leaders have talked about the need to treat more people through the primary care system or community settings, to ensure expensive hospital beds go to only the most critically ill patients.

The community health centre concept could help achieve this by bringing together in one place many of the health services people need, such as diagnostic imaging, mental health services and home care co-ordination.

The AHS report obtained by Postmedia shows the health authority has 21 project proposals — collectively valued between $5 billion and $6 billion — on its urgent priority list this year. More than half of those projects are in Edmonton, along with around 80 per cent of the costs, serving as an indication of how much neglect the city’s most important health infrastructure has endured compared with other parts of the province.

“I think the main message I see is the former (Progressive Conservative) government didn’t maintain or plan for Edmonton’s health needs,” Health Minister Sarah Hoffman said. “This is the system we have inherited, and we have a lot of work to do.”

As an opposition party, the NDP advocated strongly for immediate investments in Edmonton hospitals, particularly the Misericordia.

But since forming government, Hoffman’s party has yet to make any major funding commitments to Edmonton health facilities, apart from an increase in maintenance cash. The biggest chunk of the NDP’s health infrastructure budget has so far gone toward developing a new cancer centre in Calgary.

Hoffman said decisions on any of the recommended projects still have to go through a budget preparation process. She noted the province has already invested money to push ahead planning at both the Royal Alex and the Misericordia, which should allow construction to proceed quickly if approval is given.

As for AHS’s recommendation to scale back redevelopment plans at Misericordia to keep it operating awhile longer, Hoffman said she will take it under advisement.

“It’s one piece of the information that we will take in determining how to move forward,” she said. “Certainly the community the Misericordia serves will be served, whether it’s in a new Mis, significantly modernized Mis or a combination thereof.”

Covenant Health, the Catholic-based agency that runs the Misericordia, issued a statement from president and CEO Patrick Dumelie that called for the planning process to play out.

“We are reviewing this submission and will continue to work towards ensuring the Misericordia remains a vibrant health provider into the future,” the statement said.

In no particular order, here are 21 projects Alberta Health Services lists as its top priorities this year.

EDMONTON PROJECTS:

1. Upgrade of the energy centre for the Royal Alexandra Hospital campus: $65 million to $75 million 2. New child mental health building at the Royal Alex: $200 million 3. New clinical services building at the Royal Alex: $150 million 4. New Royal Alex bed tower, and renovations to existing treatment centre: $1.4 billion 5. Redevelopment of CapitalCare Norwood continuing care centre: $265 million 6. New Edmonton health campus hospital: No estimate given but construction of Calgary health campus in 2012 was $1.3 billion. 7: Creation of Edmonton community health centres: Price will depend on how many are built, and whether they will be new facilities or renovations to existing structures. 8. Modernization of Misericordia Hospital: No cost provided, but would be significantly less than the $2.5-billion estimate for a full redevelopment. 9: New central laboratory for medical tests: $325 million 10: Creation of “brain centre” for neurosciences at U of A hospital: $125 million, with up $20 million provided from the University Hospital Foundation. 11. Development of two central drug production and distribution centres (Edmonton and Calgary): $51 million to $58 million

CALGARY PROJECTS:

12. Redevelopment of Foothills Hospital kitchen: $62 million 13: Upgrades to Foothills power plant: $86 million to $110 million 14: Construction of Calgary cyclotron: $36 million 15: Construction of long-term care facility for complex patients: $134 million 16: Emergency and lab redevelopment at Peter Lougheed hospital: $97 million 17: New critical care unit at Rockyview Hospital: $30 million to $40 million 18: New centre for child and youth mental health: $30 million to $40 million.

OTHER PROJECTS:

19. Upgrades to medical device reprocessing at eight hospitals around Alberta: $93 million 20: New inpatient unit in Lethbridge: $32 million 21: Development of four new hub sites for laundry services: No cost provided, but past plans have suggested anywhere from $50 million to $200 million

Comments

We encourage all readers to share their views on our articles and blog posts. We are committed to maintaining a lively but civil forum for discussion, so we ask you to avoid personal attacks, and please keep your comments relevant and respectful. If you encounter a comment that is abusive, click the "X" in the upper right corner of the comment box to report spam or abuse. We are using Facebook commenting. Visit our FAQ page for more information.